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coronary microvascular dysfunction

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https://www.readbyqxmd.com/read/28643578/coronary-microvascular-dysfunction-in-diabetes-mellitus
#1
Aleksandar Kibel, Kristina Selthofer-Relatic, Ines Drenjancevic, Tatjana Bacun, Ivica Bosnjak, Dijana Kibel, Mario Gros
The significance, mechanisms and consequences of coronary microvascular dysfunction associated with diabetes mellitus are topics into which we have insufficient insight at this time. It is widely recognized that endothelial dysfunction that is caused by diabetes in various vascular beds contributes to a wide range of complications and exerts unfavorable effects on microcirculatory regulation. The coronary microcirculation is precisely regulated through a number of interconnected physiological processes with the purpose of matching local blood flow to myocardial metabolic demands...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28630445/myocardial-deformation-in-cardiac-amyloid-light-chain-amyloidosis-assessed-with-3t-cardiovascular-magnetic-resonance-feature-tracking
#2
Rui Li, Zhi-Gang Yang, Hua-Yan Xu, Ke Shi, Xi Liu, Kai-Yue Diao, Ying-Kun Guo
Clinically, assessment of myocardial function is essential in patients with amyloid light-chain cardiac amyloidosis (AL-CA) to predict outcome and determine therapeutic approach. The aim of this study was to investigate the feasibility of cardiovascular magnetic resonance (CMR)-derived feature tracking algorithm for assessing left ventricular (LV) myocardial deformation in AL-CA, and to determine if these abnormal myocardial deformation parameters are correlated to impaired LV myocardial microvascular dysfunction...
June 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28616567/cyp2c19-variants-and-epoxyeicosatrienoic-acids-in-patients-with-microvascular-angina
#3
Tomonori Akasaka, Daisuke Sueta, Yuichiro Arima, Noriaki Tabata, Seiji Takashio, Yasuhiro Izumiya, Eiichiro Yamamoto, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Ayami Kajiwara, Kazunori Morita, Kentaro Oniki, Junji Saruwatari, Kazuko Nakagawa, Seiji Hokimoto
BACKGROUND: Categorization as a cytochrome P450 (CYP) 2C19 poor metabolizer (PM) is reported to be an independent risk factor for cardiovascular disease. Epoxyeicosatrienoic acids (EETs) are metabolites of arachidonic acid by CYP2C19 epoxygenases and anti-inflammatory properties, especially in microvascular tissues. We examined the impact of CYP2C19 polymorphisms and EETs on the patients with microvascular angina (MVA) caused by coronary microvascular dysfunction. METHODS AND RESULTS: We examined CYP2C19 genotypes in patients with MVA (n = 81)...
June 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28612277/3-0%C3%A2-t-magnetic-resonance-myocardial-perfusion-imaging-for-semi-quantitative-evaluation-of-coronary-microvascular-dysfunction-in-hypertrophic-cardiomyopathy
#4
Liang Yin, Hai-Yan Xu, Sui-Sheng Zheng, Ying Zhu, Jiang-Xi Xiao, Wei Zhou, Si-Si Yu, Liang-Geng Gong
This study aimed to assess coronary microvascular dysfunction (CMD) differences in hypertrophic cardiomyopathy (HCM) patients using cardiac magnetic resonance (CMR) first-pass perfusion and late gadolinium enhancement imaging. Forty-seven patients with HCM and twenty-one healthy volunteers underwent CMR at rest. Imaging protocols included short axis cine, first-pass myocardial perfusion, and late gadolinium enhancement (LGE). Left ventricular end-diastolic wall thickness (EDTH), LGE, time to peak (Tpeak), maximal up-slope (Slopemax), and peak signal intensity (SIpeak) were assessed for each myocardial segment...
June 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28606950/pathophysiology-of-takotsubo-syndrome
#5
REVIEW
Francesco Pelliccia, Juan Carlos Kaski, Filippo Crea, Paolo G Camici
Originally described by Japanese authors in the 1990s, Takotsubo syndrome (TTS) generally presents as an acute myocardial infarction characterized by severe left ventricular dysfunction. TTS, however, differs from an acute coronary syndrome because patients have generally a normal coronary angiogram and left ventricular dysfunction, which extends beyond the territory subtended by a single coronary artery and recovers within days or weeks. The prognosis was initially thought to be benign, but subsequent studies have demonstrated that both short-term mortality and long-term mortality are higher than previously recognized...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28605043/typical-angina-is-associated-with-greater-coronary-endothelial-dysfunction-but-not-abnormal-vasodilatory-reserve
#6
Ahmed AlBadri, Derek Leong, C Noel Bairey Merz, Janet Wei, Eileen M Handberg, Chrisandra L Shufelt, Puja K Mehta, Michael D Nelson, Louise E Thomson, Daniel S Berman, Leslee J Shaw, Galen Cook-Wiens, Carl J Pepine
BACKGROUND: Typical angina (TA) is defined as substernal chest pain precipitated by physical exertion or emotional stress and relieved with rest or nitroglycerin. Women and elderly patients are usually have atypical symptoms both at rest and during stress, often in the setting of nonobstructive coronary artery disease (CAD). HYPOTHESIS: To further understand this, we performed subgroup analysis comparing subjects who presented with TA vs nontypical angina (NTA) using baseline data of patients with nonobstructive CAD and coronary microvascular dysfunction (CMD) enrolled in a clinical trial...
June 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28588675/fragmented-qrs-complex-is-a-prognostic-marker-of-microvascular-reperfusion-and-changes-in-lv-function-occur-in-patients-with-st-elevation-myocardial-infarction-who-underwent-primary-percutaneous-coronary-intervention
#7
Ruoxi Zhang, Shuyuan Chen, Qi Zhao, Meng Sun, Bo Yu, Jingbo Hou
The present study aimed to investigate the in-hospital and long-term prognostic value of fragmented QRS complex (fQRS) for microvascular reperfusion and changes in left ventricular (LV) function in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). A total of 216 patients with STEMI undergoing primary PCI were included in the current study. Patients were divided into two groups based on the presence (n=126) or absence (n=90) of fQRS following electrocardiograms (ECGs) on admission...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28585034/myocardial-perfusion-imaging-in-women-for-the-evaluation-of-stable-ischemic-heart-disease-state-of-the-evidence-and-clinical-recommendations
#8
Viviany R Taqueti, Sharmila Dorbala, David Wolinsky, Brian Abbott, Gary V Heller, Timothy M Bateman, Jennifer H Mieres, Lawrence M Phillips, Nanette K Wenger, Leslee J Shaw
This document from the American Society of Nuclear Cardiology represents an updated consensus statement on the evidence base of stress myocardial perfusion imaging (MPI), emphasizing new developments in single-photon emission tomography (SPECT) and positron emission tomography (PET) in the clinical evaluation of women presenting with symptoms of stable ischemic heart disease (SIHD). The clinical evaluation of symptomatic women is challenging due to their varying clinical presentation, clinical risk factor burden, high degree of comorbidity, and increased risk of major ischemic heart disease events...
June 5, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28577279/role-of-pet-to-evaluate-coronary-microvascular-dysfunction-in-non-ischemic-cardiomyopathies
#9
REVIEW
Paco E Bravo, Marcelo F Di Carli, Sharmila Dorbala
Coronary microvascular dysfunction (CMD) can result from structural and functional abnormalities at the intramural and small coronary vessel level affecting coronary blood flow autoregulation and consequently leading to impaired coronary flow reserve. CMD often co-exists with epicardial coronary artery disease but is also commonly seen in patients with various forms of heart disease, including dilated, hypertrophic, and infiltrative cardiomyopathies. CMD can go unnoticed without any symptoms, or manifest as angina, and/or dyspnea, and contribute to the development of heart failure, and even sudden death especially when co-existing with myocardial fibrosis...
June 3, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28576663/impact-of-ranolazine-on-coronary-microvascular-dysfunction-micro-study
#10
Bina Ahmed, Judith Mondragon, Mark Sheldon, Stacey Clegg
BACKGROUND: Patients with angina and coronary microvascular dysfunction, without evidence of structural or epicardial coronary disease (Type I CMVD) remain without evidence based treatment options. Previous work has demonstrated that ranolazine can improve angina frequency and stability among patients with Type 1 CMVD; however, the mechanism remains unclear. Therefore, the objective of this pilot project was to assess the impact of ranolazine on Type I CMVD as measured using an invasive tool to measure global resistance (index of microcirculatory resistance (IMR))...
April 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28575410/enhanced-endothelin-1-rho-kinase-signaling-and-coronary-microvascular-dysfunction-in-hypertensive-myocardial-hypertrophy
#11
Shu-Huai Tsai, Guangrong Lu, Xin Xu, Yi Ren, Travis W Hein, Lih Kuo
Aims: Hypertensive cardiac hypertrophy is associated with reduced coronary flow reserve, but its impact on coronary flow regulation and vasomotor function remains incompletely understood and requires further investigation. Methods and results: Left ventricular hypertrophy was induced in mice by transverse aortic coarctation (TAC) for 4 weeks. The left coronary artery blood velocity (LCABV) and myocardium lactate level were measured following the metabolic activation by isoproterenol...
May 29, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28574936/coronary-microcirculatory-dysfunction-in-human-cardiomyopathies-a-pathologic-and-pathophysiologic-review
#12
Kristina Selthofer-Relatic, Martina Mihalj, Aleksandar Kibel, Ana Stupin, Marko Stupin, Ivana Jukic, Akos Koller, Ines Drenjancevic
Cardiomyopathies are a heterogeneous group of diseases of the myocardium. The term cardiomyopathy involves a wide range of pathogenic mechanisms that affect the structural and functional states of cardiomyocytes, extravascular tissues, and coronary vasculature, including both epicardial coronary arteries and the microcirculation. In the developed phase, cardiomyopathies present with various clinical symptoms: dyspnea, chest pain, palpitations, swelling of the extremities, arrhythmias, and sudden cardiac death...
July 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28560002/prostaglandin-e1-protects-coronary-microvascular-function-via-the-glycogen-synthase-kinase-3%C3%AE-mitochondrial-permeability-transition-pore-pathway-in-rat-hearts-subjected-to-sodium-laurate-induced-coronary-microembolization
#13
Houyong Zhu, Yu Ding, Xiaoqun Xu, Meiya Li, Yangliang Fang, Beibei Gao, Hengyi Mao, Guoxin Tong, Liang Zhou, Jinyu Huang
Prostaglandin E1 (PGE1) is used as a pretreatment for ischemia reperfusion injury in many biological systems. However, its value as a pretreatment for coronary microembolization (CME) is unknown. The goal of this study was to determine whether PGE1 would protect against CME. In a CME rat model, we observed microthrombi and early myocardial ischemia, with endothelium appearing exfoliated and mitochondria having irregular morphology and decreased internal complexity. The level of fibrinogen-like protein 2 prothrombinase was increased and superoxide dismutase and catalase levels were decreased...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28550173/experimental-cardiac-radiation-exposure-induces-ventricular-diastolic-dysfunction-with-preserved-ejection-fraction
#14
Hirofumi Saiki, Gilles Moulay, Adam J Guenzel, Weibin Liu, Teresa Decklever, Kelly Classic, Linh Pham, Horng H Chen, John C Burnett, Stephen J Russell, Margaret M Redfield
BACKGROUND: Breast cancer radiotherapy increases the risk of heart failure (HF) with preserved ejection fraction (HFpEF). Cardiomyocytes are highly radio-resistant but radiation specifically affects coronary microvascular endothelial cells with subsequent microvascular inflammation and rarefaction. The effects of radiation on left ventricular (LV) diastolic function are poorly characterized. We hypothesized that cardiac radiation exposure may result in diastolic dysfunction without reduced EF...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28540214/coronary-microvascular-dysfunction-in-women-with-nonobstructive-ischemic-heart-disease-as-assessed-by-positron-emission-tomography
#15
REVIEW
Roxana Campisi, Fernando D Marengo
Traditional approaches for risk assessment of ischemic heart disease (IHD) are based on the physiological consequences of an epicardial coronary stenosis. Of note, normal coronary arteries or nonobstructive coronary artery disease (CAD) is a common finding in women with signs and symptoms of ischemia. Therefore, assessment of risk based on a coronary stenosis approach may fail in women. Positron emission tomography (PET) quantifies absolute myocardial blood flow (MBF) which may help to elucidate other mechanisms involved such as endothelial dysfunction and alterations in the smooth muscle cell relaxation responsible for IHD in women...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28528579/phosphodiesterase-type-5-inhibition-may-reduce-diastolic-function-in-women-with-ischemia-but-no-obstructive-coronary-artery-disease
#16
Michael D Nelson, Puja K Mehta, Janet Wei, Behzad Sharif, Louise E J Thomson, Daniel Berman, Debiao Li, C Noel Bairey Merz
BACKGROUND: Ischemia, in the absence of obstructive coronary artery disease, is prevalent in women, and associated with increased risk for major cardiovascular events. Coronary microvascular dysfunction is prevalent in these patients, and associated with impaired diastolic function. Despite our general understanding, however, optimal treatment of this cohort remains elusive. METHODS: To address this knowledge gap, we performed an open-label treatment trial to assess whether phosphodiesterase type 5 inhibition improves coronary microvascular perfusion and diastolic function in women with signs and symptoms of ischemia but no evidence of obstructive coronary artery disease...
May 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28526473/coronary-flow-reserve-is-reduced-in-sarcoidosis
#17
Seref Kul, Gonul Aciksari Kutlu, Tolga Sinan Guvenc, Murat Kavas, Kenan Demircioglu, Yusuf Yilmaz, Halil Ibrahim Yakar, Asiye Kanbay, Sibel Boga, Mustafa Caliskan
BACKGROUND AND AIMS: Sarcoidosis is a multisystem disease with frequent cardiac involvement, albeit manifest cardiac disease is rare. Though epicardial coronary arteries are not frequently involved, microvascular disease is rather common in both symptomatic and asymptomatic patients. The mechanism of microvascular involvement has not been elaborated yet. The aim of this study is to investigate coronary flow velocity reserve (CFVR) using transthoracic echocardiography in patients with sarcoidosis but without known atherosclerotic coronary artery disease or risk factors for atherosclerosis...
May 4, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28501910/targeting-the-dominant-mechanism-of-coronary-microvascular-dysfunction-with-intracoronary-physiology-tests
#18
REVIEW
Hernán Mejía-Rentería, Nina van der Hoeven, Tim P van de Hoef, Julius Heemelaar, Nicola Ryan, Amir Lerman, Niels van Royen, Javier Escaned
The coronary microcirculation plays a key role in modulating blood supply to the myocardium. Several factors like myocardial oxygen demands, endothelial and neurogenic conditions determine its function. Although there is available evidence supporting microvascular dysfunction as an important cause of myocardial ischaemia, with both prognostic and symptomatic implications, its diagnosis and management in clinical practice is still relegated to a second plane. Both diagnostic and therapeutic approaches are hampered by the broadness of the concept of microvascular dysfunction, which fails addressing the plurality of mechanisms leading to dysfunction...
May 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28501350/first-in-man-prolonged-pressure-controlled-intermittent-coronary-sinus-occlusion-to-treat-refractory-left-ventricular-dysfunction-and-ischemia-with-patent-epicardial-coronary-arteries
#19
Federico Pappalardo, Marco B Ancona, Francesco Giannini, Damiano Regazzoli, Antonio Mangieri, Matteo Montorfano, Michele De Bonis, Ottavio Alfieri, Alberto Zangrillo, Anna Mara Scandroglio, Antonio Colombo, Azeem Latib
AIMS: Pressure-controlled Intermittent Coronary Sinus Occlusion (PICSO) intermittently increases the pressure in the cardiac venous outflow tract using a balloon-tipped catheter introduced percutaneously into the coronary sinus. It aims to improve microvascular perfusion in STEMI patients during PCI, thus improving infarct healing. Its successful administration was associated with an improvement in myocardial recovery four months after primary-PCI as compared to control. However, it has never been used in other settings or for a prolonged period...
May 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28499911/aging-associated-metabolic-disorder-induces-nox2-activation-and-oxidative-damage-of-endothelial-function
#20
Lampson M Fan, Sarah Cahill-Smith, Li Geng, Junjie Du, Gavin Brooks, Jian-Mei Li
Oxidative stress attributable to the activation of a Nox2-containing NADPH oxidase is involved in the development of vascular diseases and in aging. However, the mechanism of Nox2 activation in normal aging remains unclear. In this study, we used age-matched wild-type (WT) and Nox2 knockout (KO) mice at 3-4 months (young); 11-12 months (middle-aged) and 21-22 months (aging) to investigate age-related metabolic disorders, Nox2 activation and endothelial dysfunction. Compared to young mice, middle-aged and aging WT mice had significant hyperglycaemia, hyperinsulinaemia, increased systemic oxidative stress and higher blood pressure...
May 10, 2017: Free Radical Biology & Medicine
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